Making the Case for Capsulitis

I spy something in your second toe. It’s painful and involves the ligament at the base. Let’s dig deeper. It seems like your toe and the ball of your foot hurts more when walking barefoot, and this pain makes wearing shoes and bending your toes difficult. It could be capsulitis. Let’s inspect this painful foot condition a little more closely.

Scrutinizing Capsulitis

This term refers generally to inflammation of any ligament, but we’re specifically talking about when it happens in the feet, which usually occurs in the toes. Between the bones, you have joints that are surrounded by capsular ligaments. These ligaments create a “capsule” around the whole joint that keeps the bones in place and helps the joint function properly. The problem develops when you overstretch the ligament that connects your metatarsal bones with your toe bones.

Excessive Toe Bending Named as Main Suspect

Excessive toe bending can happen when you’re crouching on your toes to pick up a ball during a golf game, pull some weeds in the garden, or fix electrical outlets for your occupation. Wearing high heels and low flats can also overstretch the ligaments at the base of your toes.

An abnormal foot structure can contribute to the development of this painful condition. The ball of the foot behind a certain toe joint may take on more pressure than other areas. Bunions, hammertoes, tight calf muscles, arch instability, and a second toe that’s longer than the big toe can also be factors in this condition.

Tell-tale Signs and Clues That Lead to Toe Joint Pain

When your toes bend too far, it’s going to create some constant pain for you, mostly in the ball of the foot. Other symptoms include swelling at the base of the toe. You may have difficulty wearing shoes and walking barefoot. Remember that every time you walk on the foot, you’re re-injuring the area. That’s why it hurts!

Capsulitis is usually not related to any sort of trauma, but rather a type of activity that aggravates the problem. It’s important for you to know that some doctors may misdiagnose your problem as Morton’s neuroma, since the symptoms are similar—especially the feeling of thickness, as if you have a bunched up sock under your toes. Be diligent in getting a proper diagnosis: try to figure out when you started feeling the pain, so we can better pinpoint the causes and prescribe treatment.

Wanted: Treatment at McDowell Orthopedics & Podiatry Group

We’ll start your treatment by taking a look at your foot and testing the joint stability. We’ll also look for potential causes and ask you what you think caused problem. There’s a possibility that we may use X-rays to rule out certain foot conditions.

For initial treatment, we advise that you rest and ice your foot. We may ask you to consider an oral anti-inflammatory medication. If your toe is starting to drift into an incorrect position, we’ll show you how to tape your toe to put it back in place.

If your pain still doesn’t go away, we can put you in a custom-made orthotic with a metatarsal pad. This will take pressure off the area and decrease the amount your toe has to bend when you walk. At this point, we can also try cortisone injections.

Shoes can make a world of difference. Avoid high heels, flip-flops, and any shoes without proper sole support. You’ll need a stiff-soled shoe with a lot of cushion in the ball of the foot.

These conservative treatments will take around four to six weeks to heal your ligaments surrounding the toes. We might try corrective surgery when you have a condition like hammertoes, since it can greatly reduce your pain.

If you have any concerns about capsulitis or pain in the ligaments at the base of your big toe, call Dr. Brian McDowell and Dr. Gavin P. Ripp at the McDowell Orthopedics & Podiatry Group. To make an appointment, dial (916) 961-3434 to reach our office in Carmichael, CA.